Clinical QuickiePulmonary
Pulmonary Embolism — Pretest Probability + D-dimer + Imaging
PE diagnosis is a pathway, not a single test.
Start with clinical probability
Use gestalt or a validated tool to decide whether D-dimer is appropriate and how aggressively to image.
D-dimer belongs in selected patients
It is most useful to rule out PE in low/intermediate-risk patients when used with the correct threshold strategy.
Imaging confirms anatomy
CT pulmonary angiography is common, but renal function, contrast issues, pregnancy context and V/Q strategies can change the imaging plan.
Risk-stratify after diagnosis
Hemodynamics, RV strain, biomarkers and comorbidities help determine severity and disposition.
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